Pharmacist and patient perspectives on recruitment strategies for randomized controlled trials: a qualitative analysis

Jane M Fletcher,David J T Campbell,Ross Tsuyuki,Marcello Tonelli,Braden J Manns,Terry Saunders-Smith,Brenda R Hemmelgarn

doi:10.1186/s12874-020-01140-6

Abstract

BackgroundAlthough recruitment is a major challenge for most randomized controlled trials, few report on the difficulties of recruitment, or how it might be enhanced. The objective of our study was to qualitatively explore the experiences of both patients and pharmacists related to recruitment for ACCESS, a large trial involving low-income seniors, given that two of our most successful recruitment strategies were direct patient recruitment materials and use of community pharmacists.MethodsUsing qualitative descriptive methods, we collected data from pharmacists and study participants. Pharmacists were asked about their impressions of the study, as well as challenges they faced and methods they used to recruit potential participants. Focus groups with trial participants centered on the patient recruitment materials. Interviews and focus groups were recorded, transcribed and analyzed using thematic analysis.ResultsPharmacists noted that their first impressions of the study were positive as they described being enticed to help the study team by the potential benefit of copayment elimination for their patients and the low time commitment. Pharmacists noted they were more likely to recruit if they were well informed on the study, as they could answer their patients’ questions. Participants noted that their primary motivations for participating were the tangible benefits of free medications and the intrinsic value of participating in research.ConclusionsWe noted that recruitment through pharmacies was an effective method as most patients have trusting relationships with their pharmacist. To optimize recruitment through pharmacies, study procedures should be straightforward, and pharmacists need to be equipped with good knowledge of the study. When promoting a study to potential participants, messaging should ensure the individuals are aware of the tangible benefits of participation while still presenting a full overview of the trial.Trial registrationTrial Registration Number: NCT02579655 – initially registered Oct 19, 2015.

Highlights

Recruitment is a major challenge for most randomized controlled trials, few report on the difficulties of recruitment, or how it might be enhanced
Pharmacists have been suggested to be especially helpful in recruiting participants [10, 11], for community-based trials, or those that focus on medications or adherence
Study aims Since pharmacists and patient-facing materials were among the most commonly used methods for recruiting for our community-based clinical trial, our objective was to use qualitative methods to better understand participants’ and pharmacists’ experiences with the recruitment process within the context of a large community-based Randomized Controlled Trial (RCT)

Summary

Introduction

Recruitment is a major challenge for most randomized controlled trials, few report on the difficulties of recruitment, or how it might be enhanced. Randomized controlled trials (RCTs) are considered the most robust study design in health research and can reduce much of the bias inherent in observational study designs [1]. Investigators often underestimate the time, costs, and difficulties involved with recruiting trial participants, as only 55% of RCTs reach their pre-specified recruitment targets [2]. Health care professionals outside of the immediate research team can be effective in recruiting patients due to pre-established relationships with patients who are potential study participants [8, 9]. Pharmacists have been suggested to be especially helpful in recruiting participants [10, 11], for community-based trials, or those that focus on medications or adherence

Objectives

Methods

Results

Discussion

Conclusion